Below-the-Knee Leg Amputation: Before Your Surgery

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What is a below-the-knee amputation?

A below-the-knee amputation is surgery to remove your leg below the knee. Your doctor removes the leg and keeps as much healthy skin, blood vessel, and nerve tissue as possible.

Having your leg removed is traumatic. You have to learn to live with new limitations. This can be hard and frustrating. You may feel depressed. Or you may grieve for your previous lifestyle. Talking with your family, friends, and health professionals about how you feel may help. You may also find it helps to talk with a person who has had an amputation.

Even though losing a limb is a challenge, it does not change who you are. It doesn't prevent you from enjoying life. You will have to learn new ways to do things. But you will still be able to work and take part in sports and activities. And you can still learn, love, play, and live life to its fullest.

Many organizations can help you adjust to your new life. Websites for some of these include www.amputeecoalitioncanada.org and www.amputee.ca.

Your doctor will tell you how much of your leg should be removed. He or she will leave enough healthy skin to cover the remaining part of your leg (residual limb). You may get an artificial leg. This is called a prosthesis. If you get one, your doctor will shape your residual limb for the best possible fit.

Your doctor may sew together the skin to cover the residual limb. Or he or she may leave it open to make sure it heals as it should. In this case, the skin may be sewn together 10 to 14 days later.

After surgery, you will stay in the hospital for several days. How long you stay depends on your general health and the way your doctor does the surgery. You may spend part of your recovery in a skilled nursing facility.

Your residual limb may heal as soon as 4 to 8 weeks after surgery. But it may take longer. You will need physical rehabilitation (rehab). The rehab can sometimes start within 48 hours of your surgery. It may last as long as 1 year.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

What happens before surgery?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for your surgery.

Preparing for surgery

  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • Tell your doctors ALL the medicines and natural health products you take. Some of these can increase the risk of bleeding or interact with anesthesia.
  • If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if you should stop taking these medicines before your surgery. Make sure that you understand exactly what your doctor wants you to do.
  • Your doctor will tell you which medicines to take or stop before your surgery. You may need to stop taking certain medicines a week or more before surgery. So talk to your doctor as soon as you can.
  • If you have an advance care plan, let your doctor know. Bring a copy to the hospital. If you don't have one, you may want to prepare one. It lets your doctor and loved ones know your health care wishes. Doctors advise that everyone prepare these papers before any type of surgery or procedure.

What happens on the day of surgery?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be cancelled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
  • Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Do not shave the surgical site yourself.
  • Take off all jewellery and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery centre

  • Bring a picture ID.
  • The area for surgery is often marked to make sure there are no errors.
  • You will be kept comfortable and safe by your anesthesia provider. You will be asleep during the surgery.
  • The surgery will take about 45 to 90 minutes.

Going home

  • Be sure you have someone to drive you home. Anesthesia and pain medicine make it unsafe for you to drive.
  • You will be given more specific instructions about recovering from your surgery. They will cover things like diet, wound care, follow-up care, driving, and getting back to your normal routine.

When should you call your doctor?

  • You have questions or concerns.
  • You don't understand how to prepare for your surgery.
  • You become ill before the surgery (such as fever, flu, or a cold).
  • You need to reschedule or have changed your mind about having the surgery.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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